I’m curious as to what your specialties/sub-specialties are… How does training and racing fit in to the hectic lifestyle?
I’m a second year student looking for some light at the end of the tunnel.
I’m starting my residency in EM next year
Pros:
-Since you work some nights, you have some days off
-Stricter work hour limitations during residency (60 hours per week in the ED, compared to 80 hours per week off-service)
-Stringing together several days off to race/travel is easier since your schedule isn’t regular to begin with
Cons:
-Swing shifts take more out of you than you think and your sleep/wake cycle gets messed up
-Working a lot of weekends and holidays so miss many normal group rides/training sessions
But I’m not there yet, so we’ll see
Jodi
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Go with primary care. Acute shortage of primary care doctors. You have regular office hours and some even take Friday afternoons off which would be good start for the long training weekends or travel to races.
And welcome to ST!
Interesting that you included DOs.
Plan on taking a break from training if you do anything worthwhile during residency/fellowship. Consider programs with solid moonlighting options and low cost of living (eg. UAB.)
Don’t go into some soft specialty like primary care, neurology, ER, etc. At least do surgery, preferably neurosurgery, if you really want to do it right. Radiology and anesthesiology have okay lifestyle/$ options while still maintaining some level of self-respect. Avoid specialties like oncology where your patients die all the time; those physicians get depressed.
I would pick a specialty with good income potential and lots of time and scheduling flexibility. The actual employment situation may be more important. It's probably better to be a solo, self-employed physician. Less, or no hospital work, limit night and E.R. coverage. Some suggestions: dermatology, rheumatology, physiatry, psychiatry. Office based family medicine or internal medicine but income can be low.
Is it too late to switch to DENTISTRY?
Anesthesia/Pain management
Anesthesia is good on the schedule after residency, mostly. Residency is harder than mostly people realize. After working 10-12 hours /day, every day you won’t want to train (at least I didn’t). But you get post-call days off. I had a lot of days that went like this, work all night, get breakfast, ride sleepily, nap, dinner with family, bedtime. If you are flexible in your training you can make it work. After residency, most groups have a tree that will let you know when you can expect to go home on any given day. Again, if you’re flexible then it works well. There are plenty of anesthesiologist athletes that I know. A lot depends on the group you join, some have a ton of night and weekend work, others none. You could also work locum tenems or part-time as an anesthesiologist. I know of guys who work only 3-4 days/week. Of course, nothing is free and your income will be lower if you work less (more time, but fewer toys).
Pain is my primary job and is a day job. I start at 7:40 or 8:40 depending on the day, finish up at 4-5 or 6, again it depends on the day, and I have very few night or weekend work commitments. I have arranged my week to take 1 afternoon off per week, which you couldn’t easily do as part of an Anesthesia group. All told, I can usually find 10 hours/week for training, consistently before work at the pool, gym, running etc, 1 weekday afternoon as much as possible, and then whatever fits into my weekends. The main variable is my family needs on the weekends and the weather. If you live in a warmer locale than Maryland or you spouse didn’t work weekends like mine, then you’d easily be able to get in more time than I do. If so, save me clif bar at the finish (no peanut butter please).
Glad you included MDs and DOs. I’m an MD but interviewed and almost went to a DO school. Being near my wife while she finished college was what made the difference. As for me, I see no difference between the two.
I am an ophthalmology sub-specialist (a vitreoretinal surgeon). I definitely do not work as hard as most surgical specialist but also do not have the same “cush” lifestyle common for the ophthalmology stereotype. My specialty deals with more ophthalmic emergencies and after hours problems.
Because I do NOT have any inpatients to see, my mornings are almost always free to get in a workout (usually swimming). If I am up in the middle of the night operating then there is no AM workout (and sometimes no workout at all that day).
Call sucks no matter what your specialty. When I am on call (every third week), I have to watch where I ride so I can stay in contact with the local EDs and pts. Even though the call is not that terrible for 70% of the time, it is the impending “what’s next” that makes it suck and hinders your ability t focus completely on your training as needed.
With that in mind, I have always said I would give up half my salary to NEVER have to take call again. This is a very sincere statement but within my area of training it is not possible. When you chose your specialty, you need to keep these issues in mind. In med school, I loved the excitement of trauma surgery (I started off in a general surgery residency before switching to ophthalmology) and neurosurgery. You become so focused on “becoming a doctor” that you can easily forget the fun out there in the world. Think long term when you choose. The money will be good no matter what. Anybody in a highly intense/demanding job (not just medicine) will have trouble finding all the time to train like a 9 to 5 person. You just do what you can and make the best of the time available (just like in med school).
Well as a surgeon, I can tell you what not to do.
This is a tough question, as the choice will be with you for the rest of your life. If linking your speciality to your triathlon lifestyle is your goal, I agree with the anesthesiologist, as they are able to sit for much of the day. I know, since while I’m on my feet for hours as they are generally reading a book or surfing the net. If I could only go back…
Also radiology is a great field as the are off their legs all day, and now with teleradiology they can also work from home.
Fields with high volume office hours are extremely taxing, and emotionally draining.
Think long and hard, as change is near impossible after a certain point in your training. Good luck…
Your question seems a little short sighted. You should choose what you want to be doing for the rest of your working life in medicine based upon what you enjoy doing in medicine, what interests you, not based upon what will give you a lifestyle to be a better triathlete. Whatever you do, if you are motivated you will find a way to do triathlon, even doing it well if you want.
I was able to figure out a way to continue running during my surgical internship - I found a house that was a good distance that allowed me to commute by running. It was only about 3 miles away so I could do it even if I felt exhausted but if I felt good and wanted to I could take a long way home.
When I was a primary care doc in the military I commuted by riding and ran at lunch.
Later, during residency, I commuted by running again.
If you end up doing a job you don’t relish so you can have more training time I will feel sorry for your patients (but not so much for you) 10-20 years from now.
hee hee, shld have been a dentist for sure! Can work whatever hours you want. But seriously shldn’t you go where your heart takes professionally, follow your passion as you discover it, your a professional, not a professional triathlete, you and your patients will be happier.
I’m an OB/Gyn, so my training rides are sometimes canceled or interrupted by deliveries etc. Private practice is so much easier than residency though, I think you’ll find that you can make time or schedule time for those things that are important to you. I think like any profession there will always be time constraints to deal with. I swim at 5:30-7:00 with the masters group and will get on the treadmill after my kids go to sleep. My MO for training is 2-3 swims, bike rides , and runs per week. I seem to do well with that schedule even for IM training. I am doing the 100 runs in 100 days and am still on track. Good Luck.
Jodi-
Great choice in specialty! I must admit up front that I am incredibly biased, as I am currently a emergency medicine resident/intern at a program in Massachusetts.
I love it, and couldn’t be happier. The way our program is set up, our intern year we have three months (2 ICU months and one trauma surg month) that are very, very hard to train properly during. The rest of the year we have a lot of time, if you are good at managing your free time well, to train or do whatever you want. Our department only does 9 hour shifts, so even days that you are working it is no problem to get training in. Also, as an intern in the ED we do 21 shifts a month, and it drops 1 shift per month per year during residency. So you get more free time as you go on. Right now I am in the ED or pedi ED for the next 3 months, which is the perfect training build up to St. A.
I am currently training about 20 hours a week. This will be my busiest and worst year, as far as free time goes, of my entire career, and I’m still managing to fit in the elite AG race at St. Anthony’s, 3 half IM’s, 2 other olympics, 1 sprint, and IM Louisville.
On a side note to the original poster, once you are an attending in EM you can easily find “full time” jobs that are 10-16 shifts per month, depending on what type of instituition you are in. I know a lot of attendings that have a ton of free time for both family, friends, and training/racing. I personally can’t imagine being in another specialty, one where during most of your residency you have to take call, or don’t have set hours. Both my wife and I would be MISERABLE if we were in anything else (she is also a EM doc…)
However, I think Frank had a great point that you should choose whatever specialty you enjoy the most, as you are going to be working much more than training no matter what field you go into. If you hate your job, you, your family, and your patients will suffer.
Best of luck with your studies and the match.
m
Do what you want to do as a sub-specialty and then find a job arrangement after training that fits your lifestyle. I am an ObGyn, certainly a specialty that can create some time constraints, but I am in an 8 person group and we each take 1 day per week off. When I’m on call, it sucks (covering for 8 doctors can get busy!), but I’m on call so infrequently that, for me, it’s worth it. I love what I do and I can’t imagine doing something else so that work wouldn’t intefere with triathlon training. If you don’t pick the specialty that you love I think you will regret it.
These are some great responses. In no way did I ever intend to choose my specialty based on training time. It’s just good to know that it is possible to have a good balance between work and play. You hear alot of negativity as a student and there’s alot of information about medicine that you just can’t find in a textbook.
I’m curious as to what your specialties/sub-specialties are… How does training and racing fit in to the hectic lifestyle?
I’m a second year student looking for some light at the end of the tunnel.
Let me state one more little philosophical thing.
You are in school for a profession that is supposed to put the interest of others before your own. I knew and know many people who got into medical school for the wrong reasons, because their families expected it, etc. and they wouldn’t be happy regardless of their specialty choice. You stated you are a second year student and looking for light at the end of the tunnel. Perhaps you ought to rexamine why you are there. The demands on your time are not going to end anytime soon.
That being said, until you have experience doing the hands on “doctor” stuff you can’t imagine what the demands of the different specialties are. Even then, you are only given a small experience before you have to make a choice so, as with almost everything in medicine, you are going to have to make a decision based upon inadequate data. Not everyone can do every specialty. Some people can’t stand patient contact, pathology, radiology, public health, or research is a better choice for them but if you love patient contact and solving problems, these would be awful jobs. Anesthesiology looks like a cushy job unless you can’t take the pressure of every patient being a potential disaster and regularly having a patient on the verge of death and their surviving depends upon decisions you make right now (hours and hours of boredome interspersed with moments of terror). It is sort of like being an ER physician but you are on your own. Each area of medicine has its pros and cons that will make it more or less enjoyable for each person depending upon their personality. It is premature for you to be worrying about this now.
“Anesthesiology looks like a cushy job unless you can’t take the pressure of every patient being a potential disaster and regularly having a patient on the verge of death and their surviving depends upon decisions you make right now (hours and hours of boredome interspersed with moments of terror).”
Anesthesia here. It’s a great job most of the time (sit and recover) but I did have an experience like that mentioned above just the other day. Surgeon accidently slashed the illiac artery. I was standing for 5 hrs loading blood products into a level one blood transfusion device…among other things, while they tried to find out where the bleeding was coming from. It took a lot out of me, but I kind of enjoy the rush I get doing that kind of thing once and a while. It’s especially rewarding when you see how well the patients did afterwards. The ultimate complement is when the patient wakes up and says in astonishment “It’s over??”
I have done fairly well managing a work, family and a demanding training schedule. On average, I would guess I work 50 hrs a week and train around 10-12 hrs a week. The call nights and weekends are a bear though;-((
Good luck with your decision.
The reason I said I was “looking for light at the end of the tunnel” was because, as I’m sure you know very well, the first two year of med school involves burying your head in books and notes and minimal patient contact.
The reason I am asking the question now is because in about a year from now I will have to decide what specialty I want to pursue. While I can sit here and say that I’m definitely interested in many different fields of medicine (even with the little experience I’ve had), my decision certainly will be made with inadequate data–just as you noted. That’s why I figured I’d ask for the opinions of people who have the experience. If not now, when would be a good time to ask for the pro’s and con’s of the different specialties?
I’ve talked to many people who love the field they have chosen…and just as many who hate theirs.
I don’t intend on choosing my profession based on an online forum…just simply looking for some info that would be hard to find elsewhere.
You will bury your head in books for a while but it’s always nice to take a break and go out for a nice “hard run” to clear the mind. There is a pro triathlete from Oklahoma who just recently finished med school…Amanda Stevens. I think she finished top in her class. Her training is legendary. She would laminate her notes and take them to the pool and, rumor has it, she would ride her trainer at the library. If there is a will there is a way;-)
“Anesthesiology looks like a cushy job unless you can’t take the pressure of every patient being a potential disaster and regularly having a patient on the verge of death and their surviving depends upon decisions you make right now (hours and hours of boredome interspersed with moments of terror).”
Anesthesia here. It’s a great job most of the time (sit and recover) but I did have an experience like that mentioned above just the other day. Surgeon accidently slashed the illiac artery. I was standing for 5 hrs loading blood products into a level one blood transfusion device…among other things, while they tried to find out where the bleeding was coming from. It took a lot out of me, but I kind of enjoy the rush I get doing that kind of thing once and a while. It’s especially rewarding when you see how well the patients did afterwards. The ultimate complement is when the patient wakes up and says in astonishment “It’s over??”
I have done fairly well managing a work, family and a demanding training schedule. On average, I would guess I work 50 hrs a week and train around 10-12 hrs a week. The call nights and weekends are a bear though;-((
Good luck with your decision.
A question for you. Did you deliberately lower the BP to around the patients ankles to help the surgeon find the cut? It is an exciting balancing act to deliberately lower the pressure to help the surgeon while at the same time trying to keep the pressure high enough to keep the patient alive and well.
The problem with anesthesia, from the psychological stress point of view, is not with those you managed to save (that is always rewarding) but with those you didn’t, those who died or suffered permanent sequellae on the table. I can remember pretty much everyone and one always wonders if one could have done more. One was a 9 yo boy who shot himself with his uncles police revolver. Another was a “routine” spleenectomy in a healthy man after a mva. He had a premonition before he went into the OR he was going to die and everyone reassured him this was pretty routine and he would be fine. Misdiagnosed and actually had a ruptured liver (in the days before routine CT). Died after we ran out of blood products to give.
Anesthesia is sort of like being an airline pilot. The routnine stuff is pretty routine and the only “stressfull” part of most flights is the take-off and landing and even those become routine. But, can you think and act calmly when disaster suddenly strikes and you need to glide your 1 passenger down gently into the Hudson river so he can walk away. Unfortunately, it isn’t always possible. It isn’t for everyone.
First of all, I’ll second pretty much everything Frank Day said. YOU have to be happy in your profession, so find what you like. Granted, you may not really know in the middle of 3rd year, when you’re doing your clinicals. But do the best you can.
My situation: didn’t do any of this tri stuff when I was in school or residency. I am a radiologist. Can see that I would have had a reasonable amount of time to train during that residency. I was working full time with a group after residency…for a few years. But they chose to not utilize teleradiology for night coverage, and it got to the point where I was exhausted and burnt out. It wasn’t pretty. I was doing triathlon by then, and it just caused more stress. Was on call one weekend/month and 2 nights/week…and with more and more CTs and stuff being ordered, was pretty much up all night on call nights. So that didn’t gel with training at all, because I would need at least a day to sleep/recover from call nights (and we worked the day after call).
So…currently, I do locums. more or less 2 weeks on, 2 weeks off. (or 1 week/1 week). I work half the year. I don’t make a zillion dollars but I can choose the schedule. I’ll work less when I have big training to do (like for IM). I make enough money to put some away, pay for my house, pay for my hobbies/tri/leisure travel.
So that’s my solution to the balance thing. it wouldn’t be for everyone, but I like it. The key is that I am HAPPY, compared to when I was burnt out and considered not being a doctor anymore. I do love what I do. When I am working, training is still with challenges, because I work in various states, so travel all the time. I’ve gotten really good at finding pool and running routes, and maximize my bike training on the weeks I’m off and at home.
One other thing…for me, I find it hard to do workouts during a work day, like at lunch (and sometimes if I have the call pager). Maybe it’s because of my old job, but I find it very hard to focus on the workout when I feel like I could be called away at any time for an urgent case.
Good luck!